SALINAS, Calif. – Dr. Pablo Romero’s clinic is filled with the happy sounds of healthy kids and pregnant moms – punctuated by the occasional wail from a youngster facing the business end of a syringe. Most of his patients work in the rich lettuce fields and packing sheds that surround this market town, and many can only afford health care for their children under a subsidized insurance program called Healthy Families.
Jointly financed by federal and state money, Healthy Families expires on Sept. 30. It’s designed for the working poor, who don’t qualify for Medicaid but can’t afford private policies, and Dr. Romero argues that strengthening the program is essential. “We could save a few bucks now,” he says, “but we’ll pay dearly 10 or 20 years down the line.”
Healthy Families is California’s version of the State Children’s Health Insurance Program (or SCHIP), and back in Washington, Congress is debating its future. The White House has vowed to veto any measure that significantly expands the program, but a brief visit to Dr. Romero’s clinic shows how Bush’s position is misguided.
Caring for kids is the moral thing to do, but it also makes financial sense. Rep. Sam Farr, D-Calif., recently wrote in the Monterey Herald that $1 spent on immunization now saves $13 down he road. Insurance costs less than $100 a month, while a single emergency room visit costs $435.
Dr. Romero, who first came to the valley as a teenage farm worker with a sixth-grade education, stresses the importance of early vaccinations: “What does it cost if a kid goes deaf from rubella?”
His latent concern is an “enormous outbreak” of diabetes. Parents work 12-hour days in back-breaking jobs and can’t supervise kids who watch too much TV, eat too much junk food and don’t get enough exercise. “Look at the number of McDonald’s outlets that have opened, and the rise in diabetes cases, and the rates are exactly the same,” he says.
The answer is prevention – regular visits to primary caregivers who teach families good health habits and monitor their progress. And those visits more than pay for themselves. Diabetes, and kidney dialysis, is far more expensive.
This message has gotten through to sensible Republicans like Sen. Orrin Hatch of Utah, who says Bush is being pennywise and pound foolish not to help kids. But the president has a remarkable ability to ignore facts, whether on the streets of Baghdad or in the clinics of Salinas. He wants to augment the program by only $5 billion over five years, not nearly enough to keep up with rising costs. If he prevails, fewer kids – not more – will be covered by insurance.
